CLINICAL AND RADIOGRAPHIC EVALUATION OF THE USE OF INTRAORAL IMPLANTS IN CONSTRUCTON OF SINGLE STAGE IMPLANT RETAINED AURICULAR PROSTHESES

Document Type : Original Article

Authors

1 Assistant lecturer, Removable Prosthodontics Department, Faculty of Dentistry, Alexandria University

2 Professor of Removable Prosthodontics Department, Faculty of Dentistry, Alexandria University, Clinical associate professor of prothodontics Department, University of Pittsburg

3 Professor of Plastic and Maxillofacial Surgery Department, Faculty of Dentistry, Alexandria University

4 Associate Professor,Department of Art as applied to Medicine, John Hopkins University, Certified Clinical Anaplastologist, Clinic Director, 3D Print Lab, Carnegie Center for Surgical Innovation.

5 Professor of Removable Prosthodontics Department, Faculty of Dentistry, Alexandria University

6 Assistant lecturer, Plastic and Maxillofacial Surgery Department, Faculty of Dentistry, Alexandria University

7 Professor, Medical Biotechnology Department, genetic Engineering and Biotechnology Research Institute, City for research and Technology Applications.

Abstract

INTRODUCTION: Although plastic surgery is capable of restoring missing tissues, it may not be the ideal choice of treatment because of the complex shape and structure. For restoration of complex organs such as ears, prosthetic restorations may be an alternative to surgical restorations due to their aesthetical success. Prosthetic rehabilitation to restore the facial disfigurements with custom made prosthetic devices may improve the level of function and patient’s self-esteem. Difficulties with facial prostheses may arise due to patient factors such as amount of soft tissue loss, location of the auricular defect, dynamic tissue beds, retentive quality of the area, and associated irritation of the tissue beds. Hence, the rehabilitation choice depends on meticulous restoration of physical dimensions, external contour, and surface landmarks to ensure satisfactory aesthetic outcomes for prosthodontists and their patients. OBJECTIVES: To use inrta-oral implant as an alternate of maxillofacial ones to retain auricular prostheses and evaluate autografted single stage implant placement surgery. MATERIALS AND METHODS: Ten patients complaining of congenitally missing ear either microtia or anotia or acquired missing ones were recruited from maxillofacial and prosthodontic departments’ outpatient clinics, Faculty of dentistry, Alexandria University. Patients were diagnosed clinically and radio-graphically using Cone Beam Computed tomography imaging (CBCT). The prosthetic ear was retained using three ball and socket attachments .They were evaluated upon radiographic and clinical level of osseointegration as well as patient acceptance and hygiene. RESULTS: None of the implants showed failure to osseointegration; providing a survival rate of 100% on both clinical and radiographic levels of evaluation. CONCLUSIONS: The use of 6 mm dental implants in the mastoid region succeeded to replace the maxillofacial implants. Single stage implant placement surgery minimized tissue traumatization and possessed higher patient satisfaction level. 

Keywords

Main Subjects

References

  1. Beumer J, Curtis TA, Firtell DN. Maxillofacial prosthetics: Surgical and Prosthodontic Considerations, St. Louis: Mosby, 1979.
  2. Semple C, Parahoo K, Norman A, McCaughan E, Humphris G, Mills M. Psychosocial interventions for patients with head and neck cancer. Cochrane Database of Systematic Reviews 2013: 41– 94.
  3. Mantri S and Khan Z. Prosthodontic Rehabilitation of Acquired Maxillofacial Defects. Head and Neck Cancer Rijeka: InTech; 2012: 315 – 36.
  4. Jaffe B. The incidence of ear diseases in the Navajo Indians. Laryngoscope. 1968;79:2126–34.
  5. Luquetti DV, Heike CL, Hing AV, Cunningham ML, Cox TC. Microtia: Epidemiology and genetics. Am J Med Genet A. 2011;158A:124–39.
  6. Horlock N, Vögelin E, Bradbury ET, Grobbelaar AO, Gault DT. Psychosocial outcome of patients after ear reconstruction: A retrospective study of 62 patients. Ann Plast Surg. 2005;54:517–24.
  7. Marx H. Die Missbildungen des ohres. In: Denker AK, editor. Handbuch der Spez Path Anatomie Histologie. Berlin: Springer; 1926:131.
  8. Meurman Y. Congenital microtia and meatal atresia; observations and aspects of treatment. AMA Arch Otolaryngol. 1957;66:443–63.
  9. Walton RL, Beahm EK. Auricular reconstruction for microtia: Part I Surgical techniques. Plast Reconstr Surg. 2002;110:234–49.
  10. Tanzer RC. Total reconstruction of the external ear. Plast Reconstr Surg Transplant Bull. 1959;23:1–15.
  11. Brent B. Microtia repair with rib cartilage grafts: A review of personal experience with 1000 cases. Clin Plast Surg. 2002;29:257–71.
  12. Reinisch JF, Lewin S. Ear reconstruction using a porous polyethylene framework and temporoparietal fascia flap. Facial Plast Surg. 2009;25:181–9.
  13. Brånemark B, Brånemark PI, Rydevik B, Myers RR. Osseointegration in skeletal reconstruction and rehabilitation: A review. J Rehabil Res Dev. 2001;38:175– 81.
  14. Hatamleh MM, Watson J. Construction of an implantretained auricular prosthesis with the aid of contemporary digital technologies: A clinical report. J Prosthodont. 2013;22:132–6.
  15. Hatamleh MM, Haylock C, Watson J, Watts DC. Maxillofacial prosthetic rehabilitation in the UK: A survey of maxillofacial prosthetists’ and technologists’ attitudes and opinions. Int J Oral Maxillofac Surg. 2010;39:1186– 92.
  16. Granström G. Craniofacial osseointegration. Oral Dis. 2007;13:261-9.
  17. Scolozzi P. , Jaques B. Treatment of mid-facial defect using prostheses supported b ITI dental implants. Plast Reconstr surg. 2004;114:1359-404.
  18. Karayazgan-Saracoglu, B.; Zulfikar, H.; Atay, A.& Gunay, Y. Treatment outcome of extraoral implants in the craniofacial region. J Craniofac Surg. 2010; 21:751-758.
  19. Karakoca, S., Aydin, C., Yilmaz, H.& Bal, B.T. Retrospective study of treatment outcomes with implant-retained extraoral prostheses: survival rates and prosthetic complications. J Prosthet Dent. 2010; 103:118- 126.
  20. Niparko JK, Langman AW, Cutler DS, Carroll WR. Tissue-integrated prostheses in the rehabilitation of auricular defects: results with percutaneous mastoid implants. Am J Otol. 1993;14:343-8.
  21. Miles BA, Sinn DP, Gion GG. Experience with cranial implant-based prosthetic reconstruction. J Craniofac Surg. 2006;17:889-97.
  22. Tjellström A. Osseointegrated implants for replacement of absent or defective ears. Clin Plast Surg 1990;17:355-66.
  23. Parel SM, Holt GR, Bränemark PI, Tjellström A. Osseointegration andfacial prosthetics. Int J Oral Maxillofac Implants 1986;1:27-9.
  24. Tjellström A, Yontchev E, Lindström J, Bränemark PI. Five years’ experience with bone-anchored auricular prostheses. Otolaryngol Head Neck Surg 1985;93:366-72.
  25. Thomas KF. Freestanding magnetic retention for extraoral prosthesis with osseointegrated implants. J Prosthet Dent 1995;73:162-5.
  26. Reisberg DJ, Habakuk SW. Hygiene procedures for implant-retained facial prostheses.J Prosthet Dent 1995;74:499-502.
  27. Lundgren S, Moy PK, Beumer J 3rd, Lewis S. Surgical considerations for endosseous implant in the craniofacial region: a 3-year report. Int J Oral Maxillofac Surg 1993;22:272-7.
  28. Seals RR Jr, Cortes AL, Parel SM. Fabrication of facial prostheses by applying the osseointegration concept for retention. J Prosthet Dent 1989;61:712-6.
  29. Arcuri MR, LaVelle WE, Fyler A , Funk G. Effects of implant anchorage on midface prostheses. J Prosthet Dent 1997;78:496-500.
  30. Khamis, M.M., Medra, A. & Gauld, J. Clinical evaluation of a newly designed singlestage craniofacial implant: a pilot study. J Prosthet Dent. 2008;100:375-383.
  31. Gitto CA, Plata WG, Schaaf NG. Evaluation of the periimplant epithelial tissue of percutaneous implant abutments supporting maxillofacial prostheses. Int J Oral Maxillofac Implants 1994;9:197-206.
  32. Granström G, Bergström K, Odersjö M, Tjellström A. Osseointegrated implants in children: Experience from our first 100 patients. Otolaryngol Head Neck Surg. 2001;125:85–92.
  33. Korus LJ, Wong JN, Wilkes GH. Long-term follow-up of osseointegrated auricular reconstruction. Plast Reconstr Surg. 2011;127:630–6.
  34. Nishimura RD, Roumanas E, Moy PK, Sugai T, Freymiller EG. Osseointegrated implants and orbital defects: U.C.L.A. experience. J Prosthet Dent, 1998;79:304-9.
  35. Wright, R.F.; Zemnick, C.; Wazen, J.J. & Asher, E. Osseointegrated implants and auricular defects: a case series study. J Prosthodont. 2008;17 :468-475.
  36. Wazen JJ, Wright R, Hatfield RB, Asher ES. Auricular rehabilitation with bone anchored titanium implants. Laryngoscope. 1999;109:523–527.
  37. Sencimen M., Bal H.E., Demirogullari M., Kocaoglu M., Dogan N. Auricular episthesis retained b an attachment system (2 case reports). Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 2008;105:28-34.
  38. Del Valle V, Faulkner G, Wolfaardt J, Rangert B, Tan HK. Mechanical evaluation of craniofacial osseointegration retention systems. Int J Oral Maxillofac Implants. 1995;10:491–498.
  39. Roumanas E, Nishimura R, Beumer J III, Moy P, Weinlander M, Lorant J. Craniofacial defects and osseointegrated implants: six-year follow-up report on the success rates of craniofacial implants at UCLA. Int J Oral Maxillofac Implants 1994;9:579-85.
  40. Gumieiro E.H., Luciano L.D., Jahn R.S., Ferreira J., Granstrom N.U. & Abrahao G. M. Bone-anchored titanium implants for auricular rehabilitation: case report and review of literature. Sao Paulo Med J 2009;127: 160- 5.

Files

Share

How to cite

Statistics